Home Visit – Community Health Nursing

HOME VISIT – COMMUNITY HEALTH NURSING (Concept of Home Visiting, Purposes, Principles, Steps and Advantages)

Updated 2024

HOME VISIT

Home visits are an integral part of community health nursing, allowing healthcare professionals to provide personalized care and support to individuals and families within their homes.

The
community health nurse work with families is in different settings including
clinics, schools, support groups, office and the family home. Home visits give
a more accurate assessment of the family structure and behavior in the natural
environment

Home visits
also provide opportunities to observe the home environment and to identify
barriers and support for reaching family health promotion goods. Health
services in the home requires technical skills, knowledge of preventive and
therapeutic measures, teaching ability, judgment and a full understanding of
human relations

Home visit
refers to meeting the health needs of people at their doorsteps. Health
services given at home for patient, family and the community in general for
nursing service and health counseling

CONCEPTS OF HOME VISITING

• Home visiting provides opportunity to
  make direct observation on home environment, family structure, familial roles
  and relationships, life style, cultural practices, group dynamics, etc. and
  make family health assessment.
• In home visiting the members are
  relaxed, have more time and privacy and feel free to raise questions, seek
  clarifications and sort out their problems
• It provides opportunities to make
  direct observation of care given by family members in planning and implementing
  family health care services
• It provides opportunities to contact
  and interact with most of the family members and establish report with the
  family as a whole
• It also make possible to have active
  participation of family members in planning and implementing family health care
• It makes feasible to plan and provide
  comprehensive family health care with major emphasis on promotive and
  preventive care

PURPOSES OF HOME VISITING

• It is a routine part of a planned
  visiting program by community health personnel
• It helps to investigate the source of
  infectious diseases
• To do follow up on some problems
  identified in the health center, school, industry or hospital
• To assess the nutritional and
  immunization status, environmental hazards
• To give health education to the
  individual, family and community
• To supervise and guide other health
  workers

PRINCIPLES OF HOME VISITING

• Need Based: home visiting should be
  planned and conducted based on the identified needs of the people
• Priority based: the home visit should
  give to the existing problem in the family. It may be maternal and child health
  services or antenatal checkup
• Regularity: plan for regular home
  visiting programs based on family needs. It should be conducted at regular
  intervals
• Flexibility: the community health
  nurse should adopt a flexible approach based on prevailing circumstances at
  home
• Scientific based: be sure of the
  scientific soundness of the subjects used for discussion. Use of technical
  skills includes hand washing an inspection
• Analysis based: collect facts about
  the home, the patient and the environment and make an objective analysis of the
  facts as an initial step in visiting the home
• Developing relationship: work with
  the person and family plan jointly. Home visiting helps to establish good
  working relationship in the family
• Sensitivity: the community health
  nurse should be sensitive to the persons feeling and needs at the time of the
  visit. Listen to the family and understand the other person’s point of view
• Educative: evaluate your own work
  remember the quality of care is more important than the number of home visits.
  It is essential to evaluate home visits from time to time

STEPS IN HOME VISITING

1. Initial phase: the community health
   nurse should collect information from clinical and other records before
   planning for a visit. During home visit, she has to assess or observe and make
   a note in initial visit

The community health nurse should introduce and establish a friendly
relationship by using simple language. Assess physical and environmental
status, family’s cultural background, occupation and income of family members,
age, educational factors and psychological factors influences

• Action phase: the interpersonal
  relationship starts when nurse enters into the house. The nurse should use
  their effective communication skills to implement the nursing process. During
  home visit, nurse practice a variety of roles when interviewing in patient
  care. The community health nurse has to take a role as collaborator,
  consultant, co-coordinator, preventor of disease, promoter of health, health
  educator and an epidemiologist, and takes steps to implement nursing process

During action phase the community health nurse provides nursing care,
e.g. taking temperature, physical examination and dressing, etc. demonstrating
and teaching, e.g. teaching insulin self-administration. She makes diagnosis
and tentative nursing care plan based on establishing priorities

• Termination phase: nurse-patient
  goals are reached, health is restored and the patient can function without
  actions. The nurse records the important events in the family and reports the
  problems of the family. Evaluation of home visit is a continuous process

ADVANTAGES OF HOME VISIT

• The nurse can directly observe home
  and family atmosphere
• The nurse can directly observe the
  care given to patient by the family members
• It is possible to discover new health
  problems
• The family members will be more
  relaxed in their own surroundings
• The family gains confidence and feels
  to clear their doubts
• This helps to apply the gained
  knowledge and skills in the homes assisting and solving individuals and
  families health problems

NURSING PROCEDURES LIST CLICK HERE

NURSING IMPORTANT QUESTIONS – CLICK HERE

NURSE FUNDAMENTAL PROCEDURES

MEDICAL SURGICAL NURSING

KEY COMPONENTS IN HOME VISITS

1. Assessment:

• Conduct a thorough assessment of the home environment, including living conditions, safety hazards, and available support systems.

2. Purpose of the Visit:

• Clearly define the purpose of the home visit, whether it is for routine check-ups, health education, medication management, post-discharge follow-up, or addressing specific health concerns.

3. Appointment and Consent:

• Schedule home visits at convenient times for the client and obtain consent for the visit. Respect the client’s privacy and autonomy.

4. Communication:

• Establish effective communication with the client and their family. Listen actively, address concerns, and encourage open dialogue to better understand their needs.

5. Cultural Competence:

• Be culturally competent and respectful of the client’s cultural practices, beliefs, and values. Consider cultural factors when planning and delivering care.

6. Safety Precautions:

• Assess and address safety concerns in the home, including fall risks, fire hazards, and other environmental factors. Provide education on maintaining a safe living space.

7. Medication Management:

• Review medications with the client, ensuring proper administration and understanding. Address any concerns or questions regarding medications.

8. Health Education:

• Provide individualized health education on topics such as chronic disease management, nutrition, hygiene, and preventive care. Use visual aids and written materials as needed.

9. Family Involvement:

• Involve family members or caregivers in the care plan, as appropriate. Consider their support and collaboration in maintaining the client’s health.

10. Health Promotion: – Encourage and facilitate healthy lifestyle choices. Discuss strategies for maintaining or improving health and preventing illness.

11. Assessment of Activities of Daily Living (ADLs): – Evaluate the client’s ability to perform daily activities, such as bathing, dressing, and eating. Provide assistance or make recommendations for improvement as needed.

12. Monitoring and Follow-up: – Establish a plan for ongoing monitoring and follow-up. Determine the frequency of home visits based on the client’s needs and the nature of the healthcare issue.

13. Documentation: – Document the home visit thoroughly, including assessments, interventions, education provided, and any changes in the client’s health status. Maintain accurate and up-to-date records.

14. Collaboration with Other Healthcare Providers: – Collaborate with other healthcare professionals involved in the client’s care, such as physicians, therapists, and social workers. Ensure a coordinated and holistic approach.

15. Respect for Autonomy: – Respect the client’s autonomy and involve them in decision-making regarding their care. Encourage them to express their preferences and goals for health and well-being.